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Organization
AGNESIAN HEALTHCARE, INC
Active
Organization
AGNESIAN HEALTHCARE, INC
Active
Other names
St. Agnes Hospital Physician Group
Organization subpart
No
Provider details
NPI number
Authorized official
JOSEPH R MINERATH (SYSTEM DIRECTOR - GOV REIMB)
(608) 445-2411
Entity
Organization
Contact information
Practice address
480 E DIVISION ST, FOND DU LAC, WI 54935-3734
(920) 926-4100
Mailing address
430 E DIVISION ST, FOND DU LAC, WI 54935-4560
Taxonomy
Speciality
Code
Description
License number
State
207RX0202X
Medical Oncology Physician
—
—
261QI0500X
Infusion Therapy Clinic/Center
—
—
261QX0200X
Oncology Clinic/Center
Primary
—
—
261QX0203X
Radiation Oncology Clinic/Center
—
—
Other
Enumeration date
12/14/2023
Last updated
12/14/2023
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